The main aspects of the immunopathogenesis of atopic dermatitis in children


Volume 66 • Issue 3 • September 2021, pp. 27-34

Received: 26.05.2021 | Publication date: 30.09.2021

A.V. Zhestkov, O.O. Pobezhimova

Samara State Medical University, Ministry of Health of Russia, Samara, Russia

Full text PDF (rus)

Research objective Atopic dermatitis (AtD) is the earliest and most frequent manifestation of the body’s hypersensitivity reaction to environmental allergens. Often manifested in severe form, affecting the skin, can occur in early infancy, childhood. The disease is genetically determined and is chronic. AtD is one of the most common skin diseases (from 20 to 40% in the structure of skin diseases), which occurs in all countries in people of both sexes. In recent years, there has been an increase in the incidence of AtD throughout the world. The disease is more common in highly developed countries and cities (less commonly in rural areas). AtD significantly reduces the quality of life of children, causing psychological discomfort and disrupting their social adaptation. AtD in children is a risk factor for the «atopic march» — the further sequential development of other allergic diseases: allergic rhinitis, pollinosis, allergic conjunctivitis, bronchial asthma. With a reduced immune response of the body, AtD in children can be complicated by the addition of a secondary infection (bacterial, viral, fungal). Such a high incidence rate, a debut in early childhood, a frequently recurring course of the pathological process, and a tendency towards an increase in the forms of the disease resistant to traditional therapy make the details of the pathogenesis of AtD particularly relevant. One of the main roles in the pathogenesis of AtD belongs to the cells of the immune system. The purpose of this article: to systematize the information available today on the immunopathogenesis of atopic dermatitis.


1. Зверев В.В., Бойченко М.Н. Медицинская микробиология, вирусология и иммунология. Т. 1. — М.: ГЭОТАР-Медиа, 2016. [Zverev V.V., Boychenko M.N. Medicinskaya mikrobiologia, virusologia i immunologia. Т. 1 — М.: GEOTAR-Media, 2016. (In Russ.)].

2. Клинические рекомендации 2020. Атопический дерматит / Общероссийская общественная организация «РОДВК», «РААКИ», «СПР». [Klinicheskii rekomendacii 2020. Atopicheskii dermatit / Obcherossiskaya obchestvennaya organizaciya «RODVK», «RAAKI», «SPR». (In Russ.)]

3. Habsik Yang, Jin Kyung Suk, Han Chang Kang, Yeon-Yeon Cho, Hye Suk Lee, Joo Yeon Lee. Skin Barrier Disorders and Immune Dysfunction in Atopic Dermatitis. International Journal of Molecular Sciences. 2020; 21(8): 286 р. DOI: 10.3390 / ijms21082867.

4. Мирзоян В.Л., Разнатовский К.И., Монахов К.Н. Атопический дерматит. Алгоритмы диагностики и лечения: учебное пособие. — СПб.: СЗГМУ им. И.И. Мечникова, 2018. — 64 с. [Mirzoyan V.L., Raznatovskii K.I., Monakhov K.N. Atopicheskii dermatit. Algoritmi diagnostiki i lechenia: uchebnoe posobie. — SPb.: SZGMU im. I.I. Mechnikova, 2018. — 64 р. (In Russ.)]

5. Козин В.М., Козина Ю.В. Клиническая дерматология: учебно-методическое пособие. — Витебск: ВГМУ, 2020. — 182 с. [Kozin V.M., Kozina U.V. Klinicheskaya dermatologia: uchebno-metodicheskoe posobie. — Vitebsk: VGMU, 2020. — 182 p. (In Russ.)]

6. Хаитов Р.М. Иммунология: учебник. — 2-е изд., перераб. и доп. — М.: ГЭОТАР-Медиа, 2015. — 528 с. [Khaitov R.M. Immunologia: uchebnik. — 2-e izd., pererab. i dop. — M.: Geotar-Media, 2015. — 528 p. (In Russ.)].

7. Peter Yip Fung Chun, Heather Lehman. Current and future monoclonal antibodies in the treatment of atopic dermatitis. J Allergy and Immunology Clinical Reviews. 2020; 59(2): 208–219 р. DOI: 10.1007 / s12016-020-08802-9.

8. Simon D., Wollenberg A., Renz H., Simon H.-U. Atopic Dermatitis: Collegium Internationale Allergologicum (CIA) Update 2019. J International Archives of Allergology and Immunology. 2019; 178(3): 207–218 р. DOI: 10.1159 / 000497383.

9. Ковальчук Л.В., Игнатьева Г.А., Ганковская Л.В. Иммунология: практикум. — М.: ГЭОТАР-Медиа, 2015. — 176 с. [Kovalchuk L.B., Ignateva G.A., Gankovskaya L.V. Immunologia: praktikum. — M.: GEOTAR-Media, 2015. — 176 p. (In Russ.)].

10. Saini S., Pansare M. New ideas and treatments for atopic dermatitis. J North American Pediatric Clinical Cases. 2019; 66(5): 1021–1033 р. DOI: 10.1016 / j.pcl.2019.06.008.

11. Зверев В.В., Хаитов Р.М. Вакцины и вакцинопрофилактика: национальное руководство. — М.: ГЭОТАР-Медиа, 2014. — 640 с. [Zverev V.V., Khaitov R.M. Vakcini i vakciniprofilaktika: nacionalnoe rukovodstvo. — M.: Geotar-Media, 2014. — 640 p. (In Russ.)].

12. Костинов М.П., Чучалин А.Г. Руководство по клинической иммунологии в респираторной медицине. — М.: ООО «АТМО», 2016. [Kostinov M.P., Chuchalin A.G. Rukovodstvo po klinicheskoy immunologii v respiratornoy medicine. — M.: OOO «ATMO», 2016. (In Russ.)].

13. Mancuso J.B., Lee S.S., Paller A.S., Yukihiro Ohya, Eichenfield L.F. Management of severe atopic dermatitis in children. J Allergy and Clinical Immunology. On practice. 2021; 9(4): 1462–1472 р. DOI: 10.1016 / j.jaip.2021.02.017.

14. Bavani F., Northcott C., Beck L., Wilfred R. Sleep Disorders and Atopic Dermatitis: Relationship, Assessment and Treatment. J Allergy and Clinical Immunology. On practice. 2021; 9(4): 1488–1500 р. DOI: 10.1016 / j.jaip.2020.12.007.

15. Мигачева Н.Б. Распространенность атопического дерматита у детей школьного возраста г. Самары. Аллергология и иммунология в педиатрии. 2019; 3 (58): с. 38–44. [Migacheva N.B. Rasprostranennost atopicheskogo dermatita u detey shkolnogo vozrasta g. Samara. Allergologia i immunologia v pediatrii. 2019; 3 (58): 38–44 р. (In Russ.)].

16. Колтуков В.К., Казюкова Т.В., Айрапетян А.С., Антипова Н.В. Атопический дерматит в детском возрасте. Медицинский совет. 2015; 1 (2): с. 60–65. [Koltukov V.K., Kazukova T.V., Ayrapetyan A.S., Antipova N.V. Atopicheskii dermatit v detskom vozraste. Medizinskii sovet. 2015; 1 (2): 60–65 р. (In Russ.)].

17. Williams H.K., Chalmers J. Prevention of atopic dermatitis. J Acta dermato-venerologica. 2020; 100(12): 213 р. DOI: 10.2340 / 00015555-3516.

18. Celest M., Walczak K., Plech T. A new look at the potential role of AhR tryptophan ligands in physiological and pathological skin processes. International Journal of Molecular Sciences. 2021; 22(3): 1104 р. DOI: 10.3390/ijms22031104.

19. Faraz Ali, Juy Vyas, Andrew and Finley. Calculating the burden: atopic dermatitis and health-related quality of life. J Acta dermato-venerologica. 2020; 100(12): 300 р. DOI: 10.2340 / 00015555-3511.

20. Погорелова Е.И., Почивалов А.В., Панина О.А., Шульга М.А., Гудкова А.Н., Хомутова Л.Н. Современный взгляд на иммунопатогенез атопического дерматита. Медицина: теория и практика. 2019; 4 (1): с. 157–163. [Pogorelova E.I., Pochivalov A.V., Panina O.A., Shulga M.A., Gudkova A.N., Homutova L.N. Sovremennii vzglyad na immunopatogenez atopicheskogo dermatita. Medicina: teoria i praktika. 2019; 4 (1): 157–163 p. (In Russ.)]

21. Silverberg J. Revolution of atopic dermatitis. J Allergy and Clinical Immunology. On practice. 2019; 140(3): 2001 р.

22. Brown S.J., Elias M., Bradley M. Genetics in Atopic Dermatitis: Historical Perspective and Future Prospects. J Acta dermato-venerologica. 2020; 100(12): 119 р.

23. Loset M., Brown S.J., Saunes M., Hvim Ch.. J Dermatology. 2019; 235 (5): 355–364 р. DOI: 10.1159 / 000500402.

24. Furue M., Yamamura K., Kido-Nakahara M. Emerging role of interleukin-31 and interleukin-31 receptor in atopic dermatitis. J Allergy. 2018; 73(1): 29–36 p. DOI: 10.1111/all.13239.

25. Sroka-Tomaszewska J., Trzeczak M. Molecular mechanisms of the pathogenesis of atopic dermatitis. International Journal of Molecular Sciences. 2021; 22(8): 4130 р. DOI: 10.3390 / ijms22084130.

26. Malik K., Heitmiller K., Czarnowicki T. An Update on the Pathophysiology of Atopic Dermatitis. Dermatol. Clin. 2017; 35(3): 317–326 p. DOI: 10.1016/j.det.2017.02.006.

27. Dinulos J.J., Trickett A., Crudel C. New science and approaches to the treatment of atopic dermatitis. J Modern opinion in pediatrics. 2018; 30(1): 161–168 р. DOI: 10.1097 / MOP.0000000000000560.

28. Fabbrocini G., Napolitano M., Megna M., Balato N., Patruno C. Treatment of atopic dermatitis with biological drugs. J Dermatology and therapy. 2018; 8(4): 527–538 р. DOI: 10.1007 / s13555-018-0258-х.

29. Moyle M., Chevikbus F., Harden J.L., Gutman-Jasski E. Understanding the immune landscape in atopic dermatitis: the era of biologics and new therapeutic approaches. J Experimental Dermatology. 2019; 28(7): 756–768 р. DOI: 10.1111 / exd.13911.

30. Kazuhisa Furu, Takamichi Ito, Gaku Tsuji, Dugarmaa Ulziy, Yen Hai Wu, Makiko Kido-Nakahara, Takeshi Nakahara, Masutaka Furu. Axis IL-13-OVOL1-FLG in atopic dermatitis. J Immunology. 2019; 158(4): 281–286 р. DOI: 10.1111 / imm.13120.

31. Masutaka Furu, Dugarmaa Ulziy, Yen Hai Wu, Gaku Tsuji, Makiko Kido-Nakahara, Takeshi Nakahara. Pathogenesis of atopic dermatitis: a modern paradigm. J Iranian Journal of Immunology. 2019; 16(2): 97–107 р. DOI: 10.22034 / IJI.2019.80253.

32. Jian-Xin Lin, Warren J. Leonard. Fine tuning of cytokine signals. J Annual Review of Immunology. 2019; 37: 295–324 р. DOI: 10.1146 / annurev-immunal-042718-041447.


Zhestkov AV, Pobezhimova OO. The main aspects of the immunopathogenesis of atopic dermatitis in children. Allergology and Immunology in Pediatrics. 2021;3(66):27–34. (In Russ.)

For correspondence:

Olga O. Pobezhimova

graduate student of Department of the general and clinical microbiology, allergology and immunology, Samara State Medical University

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